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NPI 1932209129 · Manitowoc, WI · Dermatopathology Physician
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Ling Xia is a dermatopathology physician provider located in Manitowoc, Wisconsin. This profile covers 11 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Ling Xia |
| Address | 801 York St |
| City | Manitowoc |
| State | WI |
| ZIP | 54220 |
| Taxonomy | Dermatopathology Physician |
| NPI Enumerated | September 25, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $41K |
Practice profile and service mix: Listed as a Dermatopathology Physician, the provider’s billing mix is concentrated in surgical pathology and ancillary tissue-based testing — the Medicare portfolio is dominated by surgical pathology code 88305 and includes substantial use of immunohistochemistry/immunofluorescence codes such as 88342, 88350, 88341, and 88346, indicating an operation that performs both primary diagnostic reads and in-house ancillary staining workflows. This combination of a high-volume level IV surgical pathology code with multiple antibody and fluorescence stain codes is consistent with a dermatopathology-focused lab that processes excised skin specimens and performs adjunct testing to subtype lesions.
Medicare revenue concentration: The provider reports Total Medicare revenue of $1.2M, with the precomputed top-3 Medicare codes accounting for 86.3% of that Medicare revenue. In particular, 88305 generated $880.8K (71.5% of this provider's total Medicare revenue), underscoring extreme concentration of Medicare dollars in a single high-level pathology service.
Medicaid revenue concentration: The provider’s Total Medicaid revenue is $41K and the precomputed top-3 Medicaid codes account for 100.0% of Medicaid revenue; in the available Medicaid data a single code, 88305, accounts for $40.8K (100.0% of this provider's total Medicaid revenue) across 996 claims at $41 avg paid/claim. This indicates the provider’s Medicaid activity is effectively limited to the same primary surgical pathology service billed to Medicare.
Payer mix and scale: The provider is effectively Medicare-dominant on a revenue basis, with Total Medicare revenue of $1.2M versus Total Medicaid revenue of $41K, signaling a large disparity in payer scale and exposure. For contracting or network planning this profile should be treated as a primarily Medicare-facing dermatopathology revenue stream with only modest Medicaid volume.
Medicare competitive standing on top code: For the principal Medicare contributor, 88305, the provider ranks #102 of 14580 providers nationally and sits in the 99th percentile as an "extreme outlier, far above typical national volume for this code," indicating a nationally high-volume operator for level IV surgical pathology. The secondary Medicare code 88342 also ranks highly at #172 of 11370 providers (98th percentile; "notably above typical national volume"), confirming that the provider is a major national contributor for key ancillary pathology services as well.
Medicaid competitive standing in-state: By contrast, the Medicaid ranking for 88305 is #95 of 194 providers in-state (51th percentile; typical, unremarkable volume for this code), which positions the provider as a mid-tier Medicaid participant locally despite national prominence on Medicare for the same code. This suggests the provider’s dominance is stronger in the Medicare market than in the state Medicaid market.
Tenure and operational stability: The provider’s NPI was enumerated on 2006-09-25 (~20 years ago), indicating long-standing enrollment and an established practice footprint. That tenure, combined with sustained high-volume Medicare billing for 88305 and multiple ancillary test codes, supports an interpretation of operational continuity and a mature pathology service line.
Operational implications from code mix and percentiles: The combination of a very high-volume surgical pathology code (88305: 17.3K claims, $51 avg paid/claim, $880.8K revenue) with notable volumes in immunostain and fluorescence codes (88342: 1.5K claims, $73 avg paid/claim, $109.4K revenue; 88350: 840 claims, $87 avg paid/claim, $73.1K revenue) suggests in-house capability for both primary diagnostic reads and a broad set of ancillary stains. For payers and network analysts, this pattern implies contracting should consider bundled laboratory workflows and ancillary test utilization when evaluating referrals, pricing, or utilization management for dermatopathology services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 17,270 | $50 | $880.8K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 1,500 | $70 | $109.4K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 840 | $90 | $73.1K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 800 | $80 | $63.8K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 980 | $60 | $60.6K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 210 | $110 | $23.7K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 450 | $30 | $13.6K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 40 | $60 | $2.5K |
| 88365 | The lab analyst applies an initial in situ hybridization single probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 20 | $120 | $1.8K |
| 88344 | The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 10 | $120 | $1.4K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,000 | $40 | $40.8K |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 95 | 190 | 940 | $20 | $115.2K |
Other providers in the same ZIP code as Ling Xia, ranked by combined Medicare and Medicaid revenue.
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